Bowel obstructions are one of the most frequent reasons for emergency surgery in advanced staged cancer patients. The aim of the study was to review the presentation, treatment procedures and outcomes of malignant bowel obstructions and to identify the risk factors related with poor prognosis. 376 patients were studied. Data included age, sex and medical history, presenting symptoms, physical findings on admission, ASA class, operative procedures, post operative morbidity and mortality. The most common complaints were abdominal pain, vomiting, nausea and constipation. Distension, altered bowel sound, pain and tenderness were most common find ings. Greatest value for exact diagnosis had US, X-ray examination and endoscopic examination. Primary neoplasm of the bowel was found in 84%. Obstruction due to recurrence/metastasis - in 16%. 87% were with large bowel obstruction; ileum - in 3%; both ileum and colon were involved in 8%. Perforation found in 14%. Curative resection was performed in 74,8%. Extended bowel resection - in 24%. Palliative procedures performed in patients with distant metastasis or locally advanced cancer - 25,2%. Overall morbidity - 26,9% and mortality - 11,6%; but patients with serious coexisting disease had significantly higher incidence of postoperative death - 33%.
Scripta Scientifica Medica 2007;39(1):53-57
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